RE: Neonatal puppy with congenital Heart Defect?

Anthony Dennison — Fri, 10 Apr 2020 12:19:37 GMT

Thanks for that Dave. Unfortunately the puppy deteriorated over the day and passed away over the night. I'm not sure it is a cardiac cause to be honest, but did tell the owner I would enquire.

RE: Neonatal puppy with congenital Heart Defect?

Dave Dickson — Thu, 09 Apr 2020 11:30:43 GMT

Hi Anthony

The honest answer is I don't know what is normal at this age. However, if you think about it the right heart has been facing a high pressure in utero - it can't eject much to the lungs so nearly all of the RV output goes via the ductus to the left circulation. The right heart should therefore be very hypertrophied. This resolves in the first few weeks of life and by 10-12 weeks they look like we expect.

If the heart is truly orientated the wrong way around then it is either a ventricular switch (morphological LV is attached to the PA and vice versa) or a situs inversus. However, and forgive me, but the most likely explanation is probe held the wrong way around, so check this first. You've used an abdominal probe which, by default, orientates 180 degrees to the cardiac probe so that is possible.

Another thing to consider is that with the abdominal probe, the near field will look wider and the far field narrower, in comparison to a phased array (sector) probe.

So all the changes you are seeing may be normal/artefactual from the probe.

You don't normally see the atrial septum at this age as it's so thin.

I'd rescan, try get some images from the right parasternal long-axis, and use a cardiac probe if possible to give us a better idea of what is going on.

Interesting one.

Dave